Endometriosis and the pain it causes

ABOUT one in 10 women of reproductive age suffer from a chronic and painful condition known as endometriosis. The disease can have a devastating impact on a woman's life.

Forty-two-year-old Pauline Sangham, a SABC Lotus FM presenter and producer, has endured excruciating pelvic pains for the past seven years.

"Oh my word! The pain ... the lower back pain was extreme! The pelvic pain, that was mostly on my left side, felt like I was about to have a stroke.

"It sucked out my energy. The pains would go away and come back. They were so extreme I thought I was gonna die," Sangham said.

Her condition remained a mystery for a long time until much later when she was eventually diagnosed with endometriosis.

"The people around me didn't understand this. I didn't understand it. By the time I got to actually know what endometriosis is all about, it was really too late," she said.

Symptoms caused by endometriosis can be easily mistaken for those of other illnesses, leading to delays of eight to 10 years before a correct diagnosis can be made.

"I met Professor Bagratee from the University of KZN and he sat me down the one afternoon, and we spoke about endometriosis. He showed me pictures and made me understand that it was a disease," Sangham said.

With no relief from her pains and repeated visits to her doctor, Sangham was frequently off work.

This caused problems with her employers, who became impatient with her.

"My bosses couldn't understand why I was always sick, always in pain. I always complained like an old lady.

"I'm a freelancer and that made it even more difficult because I didn't have a medical aid. And if I didn't go to work, I didn't get paid and that used to be for a lengthy period of time. It meant that I now faced a financial crisis," Sangham said.

It was not just her career that was at risk of falling apart because of endometriosis. Her personal life was also affected.

"I had drastic mood swings, I was always naggy, and I was always irritable ... everything seemed humongous. My entire relationship with my family was not a pleasant one, and I can understand why they tried to stay away from me," Sangham said.

Dr Peter Koll, a specialist obstetrician and gynaecologist in private practise in Johannesburg, said endometriosis could have a devastating effect on a woman's life in the workplace.

"Endo-metriosis does account for extra days of work lost, decreased work productivity, chronic fatigue, irritability and even depression, which all, obviously, can affect work performance," he said.

Koll said endometriosis was a chronic disease, where tissue that resembled the lining of the womb, the uterus, was found elsewhere in the body.

This tissue formed endometrial scratches, which caused internal bleeding and were most often found on the ovaries and all other organs within a woman's pelvis.

"The lining of the womb is called the endometrium. That is the lining that comes away every month with menstruation.

"When that lining gets outside the uterus and seeds out in the pelvis, you bleed internally.

"Every time you bleed externally, that sets up pain and inflammation. And that's endometriosis.

"The typical symptoms that one would watch for is painful intercourse, chronic pelvic pain and painful periods. It's prevalent to women of reproductive age.

"There is no endometriosis before puberty and there is no new endometriosis after menopause," Koll added.

He urged women not to tolerate unusual menstrual pain.

"It's not normal to suffer pain, it's not normal to stay in bed once a month with pain, it's not normal to take masses of pain killers," he said.

While endometriosis can be treated and managed, it is important it is diagnosed early. However, the disease can never be completely cured. If diagnosed late, as in the case of Pauline Sangham, it is possible for the condition to recur.

"I had a hysterectomy and it's a year later now. About a week ago I felt some pain coming back. It means I have to go back to my doctor to see if it's recurring," Sangham said.